Impact of UDST: A step forward to end TB.

BACKGROUND: India is determined to eliminate TB by 2025 despite being a high burden country. Revised National Tuberculosis Control Programme (RNTCP) is being strengthened with introduction of Universal Drug Susceptibility Testing (UDST) for Rifampicin to achieve the elimination status. METHODOLOGY: We used a before-after comparison of baseline and intervention periods (12 months each) and analyzed data viz CBNAAT performed and case detection for both drug sensitive and drug resistant TB cases. RESULTS: After implementation of Universal DST, CBNAAT performed raised from 1252 to 3137 (increased by 2.5 times); Rif sensitive cases detected raised from 458 to 1241 (increased by 2.7 times) and Rif resistant cases detected raised from 54 to 82 (increased by 1.5 times) during baseline period (2017) and intervention period (2018). CONCLUSION: We conclude that introduction of UDST for Rifampicin in RNTCP has given a significant impact with increased case detection in our study.

Prevalence of LRTI in Patients Presenting with Productive Cough and Their Antibiotic Resistance Pattern.

AIM: To find out the prevalence of Lower Respiratory Tract Infection (LRTI) such as bacterial, fungal, mycobacterial infections etc. in patients with productive cough of duration less than 15 days and to rule out the patients having previous history of tuberculosis or having treatment of tuberculosis. MATERIALS AND METHODS: Outdoor and Indoor patients of Department of Medicine and Chest & TB, SRG hospital and Jhalawar Medical College, Jhalawar were included. After sample collection the specimens were sent to the Microbiology department, for processing of Gram staining, Acid fast staining, KOH mount and bacteriological culture and sensitivity. RESULTS: A total of 200 samples were obtained from the outpatient and inpatient Department of Medicine and Chest & TB of which 66% were male and 34% were female. Seventy seven percent of samples were culture positive for both single pathogen and mixed infection of which 56.5% were male and 20.5% were female as males are more at risk for LRTI. Klebsiella pneumoniae was the most prevalent pathogen (71/193), followed by coagulase positive Staphylococci i.e. COPS (43/193). More resistant pattern was found in coagulase negative Staohylococci (CONS) showed 61.11% Methicillin Resistant Staohylococci (MRS) incidence compared to 41.86% in COPS, also regarding Extended Spectrum Beta Lactamase (ESBL) production Escherichia coli showed incidence of 36.36% as compared to other gram negative bacilli. Pseudomonas aeruginosa was the most resistant organism found based on the antibiotic susceptibility pattern while Proteus mirabilis was the most sensitive organism. CONCLUSION: Lower respiratory tract infections can spread easily among community and indiscriminate use of antibiotics contributes to their therapeutic failure. Area-wise studies on antimicrobial susceptibility profiles are essential to guide policy on the appropriate use of antibiotics to reduce the morbidity and mortality and also to control the emergence of antimicrobial resistance in local area.

Derivative 11;22 (emanuel) syndrome: a case report and a review.

Emanuel syndrome (ES) is a rare anomaly characterized by a distinctive phenotype, consisting of characteristic facial dysmorphism, microcephaly, severe mental retardation, developmental delay, renal anomalies, congenital cardiac defects, and genital anomalies in boys. Here, we report a male neonate, with the classical features of Emanuel syndrome.